Xavier Martínez Gómez

Polimiositis y dermatomiositis: incidencia en España (1997-2004)

Fundamento y objetivo: No existen estudios epidemiologicos sobre la incidencia de miopatia inflamatoria en Espana. El objetivo de este estudio fue determinar las tasas de incidencia de dermatomiositis y polimiositis y su distribucion en el territorio espanol. Material y metodo: Estudio descriptivo observacional a partir de los datos del Conjunto Minimo Basico de Datos de Altas Hospitalarias en el periodo 1997-2004. Se analizaron las variables sexo, comunidad autonoma y edad. Se calcularon las tasas de incidencia de hospitalizacion en casos por millon de habitantes y ano brutas y estandarizadas y su intervalo de confianza (IC) del 95%, en total y por comunidad autonoma. Para el analisis de tendencia del periodo estudiado, se calculo la odds ratio (OR) de tendencia mediante regresion logistica. Resultados: La tasa de incidencia total del conjunto de dermatomiositis y polimiositis fue de 8,9 (IC del 95%, 8,6-9,2) nuevos casos por millon de habitantes y ano; la de polimiositis, 3,9 (IC del 95%, 3,7-4,1), y la dermatomiositis, 4,9 (IC del 95%, 4,7-5,2). La diferencia entre las tasas de ambas enfermedades fue estadisticamente significativa (p < 0,001). La tasa de incidencia anual de ambas enfermedades disminuyo de forma significativa durante el periodo (dermatomiositis, OR de tendencia = 0,95; IC del 95%, 0,93-0,97; p < 0,001; polimiositis, OR = 0,96; IC del 95%, 0,93-0,97; p < 0,001). La incidencia de ambas enfermedades fue significativamente superior en mujeres. Las tasas de incidencia de polimiositis oscilaban en las diferentes comunidades autonomas entre 2,2 y 10,6 casos por millon de habitantes y ano y las de la dermatomiositis, entre 2,9 y 8,6 casos por habitantes y ano. Conclusiones: La incidencia de dermatomiositis y polimiositis en Espana es similar a la observada en otras zonas del mundo. La disminucion de la incidencia mantenida a lo largo del periodo y la incidencia mas alta de dermatomiositis podrian explicarse por una mejor categorizacion de estas enfermedades

Vacuna antigripal y personal sanitario: estrategias para aumentar las coberturas en un hospital de tercer nivel

BACKGROUND: The effectiveness of immunization of health-care workers (HCWs) to reduce nosocomial transmission of influenza is well established. The objective of this study is to evaluate HCWs vaccination rates in a tertiary hospital. PATIENTS AND METHOD: Data of influenza immunization rates among HCWs during two consecutive campaigns have been examined. A descriptive analysis of coverage by age, sex, occupation and job areas is performed. RESULTS: Vaccination rates ranged from 12.7 to 14.7%. Vaccine acceptance among medical residents was significantly higher than in other occupation categories (31.5 and 25.5%, respectively). HCWs at maternal and pediatric areas showed higher immunization rates. CONCLUSIONS: Despite active immunization campaigns, influenza vaccination rates among HCWs are quite low.BACKGROUND The effectiveness of immunization of health-care workers (HCWs) to reduce nosocomial transmission of influenza is well established. The objective of this study is to evaluate HCWs vaccination rates in a tertiary hospital. PATIENTS AND METHOD Data of influenza immunization rates among HCWs during two consecutive campaigns have been examined. A descriptive analysis of coverage by age, sex, occupation and job areas is performed. RESULTS Vaccination rates ranged from 12.7 to 14.7%. Vaccine acceptance among medical residents was significantly higher than in other occupation categories (31.5 and 25.5%, respectively). HCWs at maternal and pediatric areas showed higher immunization rates. CONCLUSIONS Despite active immunization campaigns, influenza vaccination rates among HCWs are quite low.

Vacunación antigripal en gestantes. Cobertura vacunal y conocimientos y prácticas de los obstetras

BACKGROUND AND OBJECTIVES Women who are pregnant during influenza season have an increased risk of infection and severe clinical disease. Several national and international organizations currently recommend vaccination for pregnant women. We intended to estimate the influenza vaccination rate in a population of postpartum women attended in a tertiary hospital in Barcelona. Moreover, we assessed the knowledge and practice of obstetricians about influenza vaccination during pregnancy. METHODS Two cross-sectional surveys were performed. Postpartum women who delivered from December 2007 to February 2008 were included. The sample of obstetricians was constituted by those who were working in hospital or primary care reference areas. RESULTS Influenza vaccination rate was 4.1%. Healthy women represented 80.5% of our population. The vaccination rate in the group with comorbidities was 3.3%. The providers who recommended the vaccine more frequently were the midwife in 28.9% and the nurse in 18.4%. Among the obstetricians, 20.9% responded that the influenza vaccine was recommended in the first trimester of pregnancy and 65.1% said that it was recommended in the second or third trimester. In relation to practice, only 7% offered the vaccine in the first trimester and 20,9% in the second or third trimester. CONCLUSIONS The influenza vaccination rate in pregnant women in our study is very low. Obstetricians showed a low level of knowledge about the current influenza vaccination recommendations, mainly in the case of first trimester of pregnancy and only few offered the vaccine in their practice.

Utilidad de la escala de Zarit reducida en demencias

BACKGROUND AND OBJECTIVES We aimed to reduce Zarit scale (ZS) for the assessment of caregiver burden in dementias. PATIENTS AND METHODS Prospective study in which the ZS was performed to 85 caregivers of patients with dementia admitted to hospital. The field explored by each item was decided by an expert committee and a logistic regression and ROC curve were performed. RESULTS A ZS reduction to 4 items was achieved with a sensitivity 98,5% and specificity of 94,7%. CONCLUSIONS A reduced Zarit scale is useful to identifiy caregiver burden in dementias. It is also easy to use.

Original breveUtilidad de la escala de Zarit reducida en demenciasShort Zarit scale in dementias

BACKGROUND AND OBJECTIVES We aimed to reduce Zarit scale (ZS) for the assessment of caregiver burden in dementias. PATIENTS AND METHODS Prospective study in which the ZS was performed to 85 caregivers of patients with dementia admitted to hospital. The field explored by each item was decided by an expert committee and a logistic regression and ROC curve were performed. RESULTS A ZS reduction to 4 items was achieved with a sensitivity 98,5% and specificity of 94,7%. CONCLUSIONS A reduced Zarit scale is useful to identifiy caregiver burden in dementias. It is also easy to use.